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. 2023:115:33-62.
doi: 10.1016/bs.acc.2023.03.003. Epub 2023 Mar 29.

Advances in TB testing

Jayson V Pagaduan  1 , Ghaith Altawallbeh  2
Affiliations

Advances in TB testing

Jayson V Pagaduan et al. Adv Clin Chem. 2023.

Abstract

Globally, tuberculosis (TB) was the leading cause of death from a single infectious agent until the coronavirus (COVID-19) pandemic. In 2020, an estimated 10 million people fell ill with TB and a total of 1.5 million people died from the disease. About one-quarter of the global population, almost two billion people, is estimated to be latently infected with Mycobacterium tuberculosis (MTB). Although latent TB infection (LTBI) is asymptomatic and noncontagious, about 5-10% of LTBI patients have a lifetime risk of progression to active TB. The diagnosis and treatment of active cases are extremely vital for TB control programs. However, achieving the End TB goal of 2035 without the ability to identify and treat the pool of latently infected individuals will be a big challenge. To do so, improved technology to provide more accurate diagnostic tools and accessibility are crucial. Therefore, this chapter covers the current WHO-endorsed tests and advances in diagnostic and screening tests for active and latent TB.

Keywords: Interferon gamma release assays; Latent TB infection; Mycobacterium tuberculosis; Nucleic acid amplification test; Tuberculin skin test; Tuberculosis; Tuberculosis antigen-based skin test.

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Figures

Fig. 1
Fig. 1
TB testing algorithm and interpretation using AFB and NAAT results . AFB and NAAT has faster turn-around time compared to bacterial culture. These two tests can be used to guide the management of patients suspected of having TB based on clinical symptoms and chest x-ray abnormalities.
Fig. 2
Fig. 2
Summary of diagnostic algorithm utilizing smear, bacterial culture and NAAT as recommended by WHO TB diagnosis guideline in 2010.
Fig. 3
Fig. 3
Diagnostic algorithm for LTBI utilizing clinical symptoms, chest X-rays, TST or IGRA as recommended by WHO’s updated and consolidated guidelines, 2018.
See this image and copyright information in PMC

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